Comparative Take on Bao He Wan

“保和丸，治一切食积。”(Bao He Wan, to treat all food stagnation.)

Bao He Wan is an herbal formula created by Zhu Dan Xi (朱丹溪). It is documented in his book 《丹溪心法》as treatment for what is termed food stagnation (食积). Especially useful if one feels a bloating sensation in the stomach after a meal, a sign of possible indigestion. We already have the TCM explanation for this formula make-up. It would hence be more useful for readers if we compare the ingredient of Bao He Wan with their biopharmaceutical peers.

The original formula is made up of three broad categories of herbs. The first are the digestives, akin to the enzymes e.g. protease, lipase, amylase that we use to aid digestion. Shan Zha (山楂), also known for helping weight loss and treating high blood lipids, is known traditionally to digest meats. Lai Fu Zi (莱菔子) is the seed of radish, and is known for breaking down wheat – remember, this is usually wheat in bread and noodles. Last of all, we have Shen Qu (神曲) which if simplified is a cocktail of enzymes.

In today’s formulations of Bao He Wan, we also see other herbs being included, most common of which is maiya (麦芽). Zhishi (枳实)and baishu (白术) are also wont to be thrown into the mix.

“人有食积，必生痰湿。” (He who is wrought with food stagnation, will produce phelgm and damp.)

In TCM, there is a saying that when there is food stagnation, phlegm-stagnation will appear. Which is why the second group of is erchen tang (二陈汤) but without licorice.

“食积日久则易生热。” (Food stagnation over time will generate heat.)

There is also another idea that the long-term result of food stagnation is heat generation. This is understandable, as in the case of chronic gastritis, where there is slight inflammation of the stomach lining. The original formula uses lian qiao (连翘) in response. These days, the solution would be the use of antacids like aluminium hydroxide and magnesium hydroxide.

That said, there is an obvious difference between the use of lian qiao as an anti-inflammatory and the use of antacids to neutralize excess acid production. One can read up on content by alternative medicine practitioners who believe that the problem is not excess acid production in the stomach; instead they believe it is the lack of acid production.

As mentioned above, qi regulators like houpu (厚朴) and zhishi (枳实) are thrown in to regulate qi and take away any bloating. While there is not clear connection, we can liken this to the use of anti-flatulent medications like simethicone (西甲硅油) or to gastroprokinetics like mosapride (莫沙必利) or cisapride (西沙必利).